Electrochemical sensor module

ABSTRACT

Certain embodiments of a sensor cartridge element include a sensor module, an electrode arrangement installed on the sensor module, and a delivery arrangement securely coupled to the sensor module. The sensor module includes an analysis cell and a skin piercing member. The electrode arrangement generates an electrical signal when exposed to a fluid sample collected in the analysis cell. The delivery arrangement includes a drug reservoir, a piston chamber, and a valve arrangement providing selective fluid communication between the drug reservoir and the piston chamber. Metering electronics and an actuator can manage collection of fluid samples and/or dispensing of drug doses.

This application is a Continuation of U.S. application Ser. No. 15/269,204, filed 19 Sep. 2016, which is a Continuation of U.S. application Ser. No. 13/129,343, filed 19 Jul. 2011, now U.S. Pat. No. 9,445,755, which is a National Stage Application of PCT/US2009/064228, filed 12 Nov. 2009, which claims benefit of Ser. No. 61/114,844, filed 14 Nov. 2008 in the USA and which applications are incorporated herein by reference. To the extent appropriate, a claim of priority is made to each of the above disclosed applications.

TECHNICAL FIELD

The present disclosure relates to sensors for measuring one or more bioanalytes and to methods for making such sensors. The present disclosure also relates to systems and methods for delivering therapy based on the measured bioanalyte.

BACKGROUND

Electrochemical bio-sensors have been developed for detecting analyte concentrations in a given fluid sample. For example, U.S. Pat. Nos. Nos. 5,264,105; 5,356,786; 5,262,035; 5,320,725; and 6,464,849, which are hereby incorporated herein by reference in their entireties, disclose wired enzyme sensors for detecting analytes, such as lactate or glucose. Wired enzyme sensors have been widely used in blood glucose monitoring systems adapted for home use by diabetics to allow blood glucose levels to be closely monitored. Other example types of blood glucose monitoring systems are disclosed by U.S. Pat. Nos. 5,575,403; 6,379,317; and 6,893,545.

SUMMARY

One aspect of the present disclosure relates to a sensor system that can be manufactured in reduced scale and that can be conveniently handled by consumers.

Another aspect of the present disclosure relates to a sensor module including a molded body that defines an analyte analysis cell and also integrates a skin piercing element, such as a lancet or canula, into the molded body.

A further aspect of the present disclosure relates to an electrochemical sensor module having a configuration that facilitates mounting a plurality of the sensor modules in a module that can easily and conveniently be handled by a consumer.

A further aspect of the present disclosure relates to a glucose monitoring system that integrates a glucose monitor, a skin piercing mechanism, a syringe, an insulin vial, and one or more glucose sensors into a user-friendly glucose monitoring kit.

Still another aspect of the present disclosure relates to an electrochemical sensor module for use in a sensor system that can be efficiently manufactured (e.g., using a continuous manufacturing process such as a continuous insert molding process).

A variety of additional aspects will be set forth in the description that follows. The aspects can relate to individual features and to combinations of features. It is to be understood that both the forgoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the broad concepts upon which the embodiments disclosed herein are based.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an isometric view of a sensor module configured to obtain a fluid sample in accordance with the principles of the present disclosure;

FIG. 2 is an isometric view of a first housing portion of the sensor module of FIG. 1 shown in cross-section so that interior structures of the sensor module are visible, the first housing portion being configured in accordance with the principles of the present disclosure;

FIG. 3 is another isometric view of the first housing portion of FIG. 2 with a skin piercing member being slideably mounted on the first housing portion in accordance with the principles of the present disclosure;

FIG. 4 is another isometric view of the first housing portion of FIG. 3 with first and second electrodes being arranged on the first housing portion in accordance with the principles of the present disclosure;

FIG. 5 is a bottom, isometric view of a cartridge element including the sensor module of FIG. 1 coupled to a delivery arrangement in accordance with the principles of the present disclosure;

FIG. 6 is a top, isometric view of the cartridge element of FIG. 5 in accordance with the principles of the present disclosure;

FIG. 7 is a plan view of the cartridge element of FIG. 5 in accordance with the principles of the present disclosure;

FIG. 8 is a side view of the cartridge element of FIG. 5 from the second side in accordance with the principles of the present disclosure;

FIG. 9 is an end view of the cartridge element of FIG. 5 in accordance with the principles of the present disclosure;

FIG. 10 is an isometric view of the cartridge element of FIG. 5 shown in cross-section such that the skin piercing member, electrodes, and drug reservoir are visible in accordance with the principles of the present disclosure;

FIG. 11 is a plan, cross-sectional view of the cartridge element of FIG. 10 in accordance with the principles of the present disclosure;

FIG. 12 is an isometric view of the cartridge member of FIG. 10 including a piston chamber mounted to the delivery arrangement in accordance with the principles of the present disclosure;

FIG. 13 is a top, isometric view of multiple cartridge elements stacked into a cartridge assembly in accordance with the principles of the present disclosure;

FIG. 14 is another top, isometric view of the cartridge assembly of FIG. 13 in accordance with the principles of the present disclosure;

FIG. 15 is a bottom, isometric view of the cartridge assembly of FIG. 13 in accordance with the principles of the present disclosure;

FIG. 16 is another bottom, isometric view of the cartridge assembly of FIG. 13 in accordance with the principles of the present disclosure;

FIG. 17 is a side view of the cartridge assembly of FIG. 13 in accordance with the principles of the present disclosure;

FIG. 18 is a distal end view of the cartridge assembly of FIG. 13 in accordance with the principles of the present disclosure;

FIG. 19 is a proximal end view of the cartridge assembly of FIG. 13 in accordance with the principles of the present disclosure;

FIG. 20A is a schematic block diagram of a monitoring and delivery system in accordance with the principles of the present disclosure;

FIG. 20B is a plan view of the cartridge assembly of FIG. 13 shown in cross-section with a piston rod visible in accordance with the principles of the present disclosure;

FIG. 21 is a top, isometric view of first, second, and third drive mechanisms interacting with the cartridge element of FIG. 13 in accordance with the principles of the present disclosure;

FIG. 22 is a plan view of the first, second, and third drive mechanisms and the cartridge element of FIG. 21 in accordance with the principles of the present disclosure;

FIG. 23 is a bottom, isometric view of the first, second, and third drive mechanisms and the cartridge element of FIG. 21 in accordance with the principles of the present disclosure;

FIG. 24 is a top, isometric view of first, second, and third drive mechanisms and the cartridge element of FIG. 21 mounted on a base to form a drive system in accordance with the principles of the present disclosure;

FIG. 25 is a plan view of the drive system and base of FIG. 24 in accordance with the principles of the present disclosure;

FIG. 26 is a side, isometric view of the drive system of FIG. 24 in accordance with the principles of the present disclosure;

FIG. 27 is a top, isometric view of a cartridge assembly mounted on the drive system of FIG. 24 in accordance with the principles of the present disclosure;

FIG. 28 is a side view of the cartridge assembly and drive system of FIG. 27 in accordance with the principles of the present disclosure;

FIG. 29 is a proximal end view of the cartridge assembly and drive system of FIG. 27 in accordance with the principles of the present disclosure;

FIG. 30 is a front, top isometric view of a monitoring and delivery device in accordance with the principles of the present disclosure;

FIG. 31 is a front view of the monitoring and delivery device of FIG. 30 in accordance with the principles of the present disclosure;

FIG. 32 is a side view of the monitoring and delivery device of FIG. 30 in accordance with the principles of the present disclosure;

FIG. 33 is a top, isometric view of the monitoring and delivery device of FIG. 30 shown is a first door open and a cartridge assembly being loaded into an interior of the device via a first port in accordance with the principles of the present disclosure;

FIG. 34 is a bottom, isometric view of the cartridge assembly being loaded into the monitoring and delivery device of FIG. 33 in accordance with the principles of the present disclosure;

FIG. 35 is a front view of the cartridge assembly being loaded into the monitoring and delivery device of FIG. 33 in accordance with the principles of the present disclosure;

FIG. 36 is a side view of the monitoring and delivery device of FIG. 33 with the door being open and the first port being visible in accordance with the principles of the present disclosure;

FIG. 37 is a bottom, isometric view of the monitoring and delivery device of FIG. 33 with a portion of the bottom and a portion of the front walls removed from the housing such that the cartridge assembly loaded within the interior of the housing is visible in accordance with the principles of the present disclosure;

FIG. 38 is a top, isometric view of the monitoring and delivery device of FIG. 33 with portions of the front, first side, and bottom removed in accordance with the principles of the present disclosure;

FIG. 39 is a front, bottom isometric view of a cartridge element being ejected from the monitoring and delivery device of FIG. 33 through a third port in accordance with the principles of the present disclosure; and

FIG. 40 is a bottom, isometric view of the cartridge element being ejected from the monitoring and delivery device of FIG. 39 in accordance with the principles of the present disclosure.

DETAILED DESCRIPTION

Reference will now be made in detail to exemplary aspects of the present disclosure which are illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.

The following definitions are provided for terms used herein:

A “working electrode” is an electrode at which the analyte (or a second compound whose level depends on the level of the analyte) is electrooxidized or electroreduced with or without the agency of an electron transfer agent.

A “reference electrode” is an electrode used in measuring the potential of the working electrode. The reference electrode should have a generally constant electrochemical potential as long as no current flows through it. As used herein, the term “reference electrode” includes pseudo-reference electrodes. In the context of the disclosure, the term “reference electrode” can include reference electrodes which also function as counter electrodes (i.e., a counter/reference electrode).

A “counter electrode” refers to an electrode paired with a working electrode to form an electrochemical cell. In use, electrical current passes through the working and counter electrodes. The electrical current passing through the counter electrode is equal in magnitude and opposite in sign to the current passing through the working electrode. In the context of the disclosure, the term “counter electrode” can include counter electrodes which also function as reference electrodes (i.e., a counter/reference electrode).

A “counter/reference electrode” is an electrode that functions as both a counter electrode and a reference electrode.

An “electrochemical sensing system” is a system configured to detect the presence and/or measure the level of an analyte in a sample via electrochemical oxidation and reduction reactions on the sensor. These reactions are converted (e.g., transduced) to an electrical signal that can be correlated to an amount, concentration, or level of an analyte in the sample. Further details about electrochemical sensing systems, working electrodes, counter electrodes and reference electrodes can be found at U.S. Pat. No. 6,560,471, the disclosure of which is hereby incorporated herein by reference in its entirety.

“Electrolysis” is the electrooxidation or electroreduction of a compound either directly at an electrode or via one or more electron transfer agents.

An “electron transfer agent” is a compound that carries electrons between the analyte and the working electrode either directly or in cooperation with other electron transfer agents. One example of an electron transfer agent is a redox mediator.

A “sensing layer” is a component of the sensor which includes constituents that facilitate the electrolysis of the analyte. The sensing layer may include constituents such as an electron transfer agent, a catalyst which catalyzes a reaction of the analyte to produce a response at the electrode, or both.

FIGS. 1-4 illustrate a sensor module 100 configured in accordance with the principles of the present disclosure. The sensor module 100 includes a module body 101 having a distal end 102 positioned opposite from a proximal end 103. The module body 101 is preferably constructed of a molded plastic material. For example, in one embodiment, the module body 101 includes a first molded piece 110 secured to a second molded piece 120 at a part line 105. In one embodiment, the parts 110, 120 are molded using a manufacturing process such as a continuous insert micro-molding process. Details regarding one example of such a manufacturing process can be found in copending application Ser. No. 61/114,856 (having attorney docket no. 11554.12USP1), filed Nov. 14, 2008, the disclosure of which is hereby incorporated by reference herein.

The module body 101 includes an analysis cell housing 104 positioned adjacent the distal end 102 and a skin piercing member anchor 106 positioned adjacent the proximal end 103. A flexible linkage 130 mechanically connects the analysis cell housing 104 to the skin piercing member anchor 106. The flexible linkage 130 is configured to allow the analysis cell housing 104 and the skin piercing member anchor 106 to move relative to one another along an axis A that extends through the module body 101 from the proximal end 106 to the distal end 104. The analysis cell housing 104 defines an analysis cell 112 (FIGS. 2-4) at which a fluid sample (e.g., a blood sample) can be analyzed using a sensor structure, such as a wired enzyme sensor arrangement, in fluid communication with the analysis cell 112.

The sensor module 100 also includes a skin piercing member 108 (e.g., a cannula, a needle, a lancet, or other structure) aligned along the axis A (see FIG. 3). The skin piercing member 108 includes a base end 107 positioned opposite from a piercing tip 109. The base end 107 of the skin piercing member 108 is secured to the skin piercing member anchor 106 and the skin piercing member 109 extends distally from the skin piercing member anchor 106 through a passage 114 defined by the analysis cell housing 104. The passage 114 includes a distal end 115 positioned opposite from a proximal end 116. The passage 114 includes a capillary slot 113 (FIGS. 2 and 3) that provides fluid communication between the analysis cell 112 and the passage 114.

In use of the sensor module 100, the distal end 102 of the module body 101 is placed against a patient's skin at a sampling location where it is desired to take a fluid (e.g., blood) sample. The distal end 102 is configured to stabilize an interface between the module body 22 and the patient's skin when a fluid sample is being taken. The distal end 102 includes a circular, skin engaging surface 118 concentrically aligned with respect to the axis A. When a fluid sample is being taken, the skin engaging surface 118 is pressed against the patient's skin at the sampling location to stabilize the module body 101 and to facilitate insertion of the skin piercing member 108 into the patient's tissue. Once the distal end 102 is in contact with the skin, the skin piercing member anchor 106 can be driven distally along the axis A by an actuator (i.e., a driver) that couples to the skin piercing member anchor 106. Further details regarding some suitable drivers will be provided herein with respect to FIGS. 21-29.

As the skin piercing member anchor 106 is driven distally, the skin piercing member 108 slides within the passage 114 from a retracted position (see FIG. 3) to an extended position (not shown) at which the tip 109 of the skin piercing member 108 extends distally beyond the distal end 102 of the module body 101. The distance the tip 109 of the skin piercing member 108 extends beyond the distal end 102 of the module body 101 is preferably selected to ensure that a blood sample will be drawn efficiently. The skin piercing member anchor 106 is then pulled back proximally by the actuator causing the tip 109 of the skin piercing member 108 to be retracted back into the passage 114.

Penetration by the skin piercing member 108 into the patient's tissue at a wound site causes a blood sample from the wound site to enter the passage 114 and flow by capillary action through the capillary slot 113 to the analysis cell 112. At the analysis cell 112, an analyte level (e.g., the blood glucose level) in the blood sample is sensed by the wired enzyme sensor arrangement that is typically coupled (e.g., wired) to a controller, such as a microcontroller, a mechanical controller, a software driven controller, a hardware driven controller, a firmware driven controller, etc. The controller can include a microprocessor that interfaces with memory. The controller would typically be integrated into an analyte monitor, such as a glucose monitor, having user interfaces for receiving user input (e.g., buttons and switches) and/or providing user output (e.g., a display for displaying the sensed analyte reading). Additional details regarding an example controller suitable for use with the sensor module 100 are provided herein with respect to FIGS. 21-29.

The flexible linkage 130 of the module body 101 preferably has a compressible configuration that enables the flexible linkage 130 to compress axially along axis A as the skin piercing member anchor 106 moves the skin piercing member 108 from the retracted position to the extended position. As shown in FIGS. 1-4, one example flexible linkage 130 includes two linkage members 131, 132. Each linkage member 131, 132 has a first end integrally formed with the skin piercing member anchor 106 and a second end integrally formed with the analysis cell housing 104.

Each of the linkage members 131, 132 includes an intermediate flex or hinge point (e.g., a central hinge point) 133, 134, respectively, that enables the linkage member 131, 132 to flex radially outwardly relative to the axis A when the skin piercing member anchor 106 is moved in a distal direction relative to the analysis cell housing 104. The flex or hinge points 133, 134 also enable the linkage members 131, 132 to flex radially inwardly toward the central axis A when the skin piercing member anchor 106 is moved in a proximal direction relative to the analysis cell housing 104. Accordingly, the linkage members 131, 132 expand radially outwardly from the axis A to provide axial shortening of the linkage members 131, 132 along the axis A, and contract radially toward the axis A to allow axial lengthening of the linkage members 131, 132 along the axis A. The flexible linkage 130 also can be referred to as a “dynamic linkage” since it allows for relative movement between the skin piercing member anchor 106 and the analysis cell housing 104.

The passage 114 of the analysis cell housing 104 includes a tapered portion 114 a, a sample transport portion 114 b, and a skin piercing member guide portion 114 c (see FIG. 2). The tapered portion 114 a has a taper that narrows as the tapered portion 114 a extends in a proximal direction through the analysis cell housing 104. As depicted at FIGS. 2 and 3, the tapered portion 114 a of the passage 114 has a truncated, conical shape with a major diameter adjacent the skin engaging surface 102 and a minor diameter adjacent the capillary slot 113. The fluid sample enters the analysis cell housing 104 through the tapered portion 114 a of the passage 114.

The sample transport portion 114 b extends along the axis A from the tapered portion 114 a to the analysis cell 112. The sample transport portion 114 b has a larger transverse cross-sectional area than the skin piercing member guide portion 114 c. The larger cross-section provided is sized to provide a capillary space along the skin piercing member 108 for allowing the blood sample to travel by capillary action from the tapered portion 114 a of the passage 114 to the analysis cell 112. In this way, the transport portion 114 b provides a direct path for transporting the fluid sample from the interface of the wound site generated by the skin piercing member 108, up along the outer surface of the skin piercing member 108, through the capillary slot 113, and into the analysis cell 112. Hydrophilic coatings, selective surface treatments, and/or certain moldable polymers can be used to enhance capillary transport along the sample transport portion 114 b of the passage 114.

The skin piercing member guide portion 114 c of the passage 114 is preferably sized such that it will provide minimum concentric clearance around the skin piercing member 108. In this way, when the skin piercing member 108 is mounted within the passage 114, the skin piercing member guide portion 114 c of the passage 114 allows the skin piercing member 108 to slide within the passage 114 while preventing substantial passage of blood or other interstitial fluid proximally beyond the sample transport portion 114 b of the passage 114.

As indicated above, the skin piercing member 108 is secured to the skin piercing member anchor 106. For example, the proximal end 113 of the skin piercing member 108 can be press-fit, adhesively bonded, or otherwise secured within a groove 117 (FIG. 2) defined by the skin piercing member anchor 106 at a location along the axis A. In one embodiment, the groove 117 extends across an opening 119. While the opening 119 is shown as a through-hole, it will be appreciate that the opening 119 could also be a blind hole. Other connection techniques, such as fasteners, snap-fit connections, or other securement arrangements, also could be used to secure the skin piercing member 108 to the piercing member anchor 106.

The analysis cell 112 defined by the analysis cell housing 104 is elongated in a direction that is generally perpendicular relative to the axis A of the passage 114. The analysis cell 112 has a first end in fluid communication with the capillary slot 113 leading to the sample transport portion 114 b of the passage 114 and an opposite, second end at which a vent 111 is defined. The length of the analysis cell 112 is aligned along an axis B (see FIG. 3) that is perpendicular relative to the axis A defined by the passage 114.

First and second electrodes 140, 142 extend across the analysis cell 112 in a direction generally perpendicular to the axis B of the analysis cell 112 (see FIG. 4). At least the first electrode 140 generates a signal (e.g., an electrical signal) indicating an analyte concentration level of the sample fluid contained in the analysis cell 112. The analysis cell housing 104 can include contact receivers (e.g., receptacles, pads, slots, or other structures) 121, 123 for receiving and retaining electrode contacts 144, 146 (see FIG. 2). The electrodes 140, 142 extend over the electrode contacts 144, 146 and are configured to transfer the generated signal to the electrode contacts 144, 146. The electrode contacts 144, 146 include exposed tips 148, 150, respectively, protruding outwardly from the analysis cell housing 104 to enable transmission of the analyte concentration level signal to a processor (e.g., see processor 310 of FIG. 21).

In one embodiment, the first electrode 140 is in contact with a sensing layer and functions as a working electrode and the second electrode 142 can function as a reference/counter electrode. In other embodiments, separate working, reference and counter electrodes can be provided in fluid communication with the analysis cell 112. The electrodes 140, 142 are preferably threads, fibers, wires, or other elongated members. The analysis cell housing 104 can include electrode mounting structures in which the electrodes 140, 142 are secured. For example, in one embodiment, the electrode mounting structures can include grooves 122, 124 (e.g., V-grooves) that extend through the analysis cell housing 104 in a direction generally perpendicular relative to the axis B of the analysis cell 112.

In one embodiment, the working electrode 140 can include an elongated member that is coated or otherwise covered with a sensing layer and the reference/counter electrode 142 can include any elongated member, such as a wire or fiber that is coated or otherwise covered with a layer, such as silver chloride. Preferably, at least a portion of each elongated member is electrically conductive. In certain embodiments, each elongated member can include a metal wire or a glassy carbon fiber. In still other embodiments, each elongated member can each have a composite structure and can include a fiber having a dielectric core surrounded by a conductive layer suitable for forming an electrode.

A preferred composite fiber is sold under the name Resistat® by Shakespeare Conductive Fibers LLC. This composite fiber includes a composite nylon, monofilament, conductive thread material made conductive by the suffusion of about a 1 micron layer of carbonized nylon isomer onto a dielectric nylon core material. The Resistat® material is comprised of isomers of nylon to create the basic two layer composite thread. However, many other polymers are available for the construction, such as: polyethylene terephthalate, nylon 6, nylon 6,6, cellulose, polypropylene cellulose acetate, polyacrylonitrile and copolymers of polyacrylonitrile for a first component and polymers such as of polyethylene terephthalate, nylon 6, nylon 6,6, cellulose, polypropylene cellulose acetate, polyacrylonitrile and copolymers of polyacrylonitrile as constituents of a second component. Inherently conductive polymers (ICP) such as doped polyanaline or polypyrolle can be incorporated into the conductive layer along with the carbon to complete the formulation. In certain embodiments, the ICP can be used as the electrode surface alone or in conjunction with carbon. The Resistat® fiber is availability in diameters of 0.0025 to 0.016 inches, which as suitable for sensor electrodes configured in accordance with the principles of the present disclosure. Example patents disclosing composite fibers suitable for use in practicing sensor modules configured in accordance with the principles of the present disclosure include U.S. Pat. Nos. 3,823,035; 4,255,487; 4,545,835 and 4,704,311, which are hereby incorporated herein by reference in their entireties.

The sensing layers provided at working electrodes of sensor modules configured in accordance with the principles of the present disclosure can include a sensing chemistry, such as a redox compound or mediator. The term redox compound is used herein to mean a compound that can be oxidized or reduced. Example redox compounds include transition metal complexes with organic ligands. Preferred redox compounds/mediators include osmium transition metal complexes with one or more ligands having a nitrogen containing heterocycle such as 2,2′-bipyridine. The sensing material also can include a redox enzyme. A redox enzyme is an enzyme that catalyzes an oxidation or reduction of an analyte. For example, a glucose oxidase or glucose dehydrogenase can be used when the analyte is glucose. Also, a lactate oxidase or lactate dehydrogenase fills this role when the analyte is lactate. In sensor systems, such as the one being described, these enzymes catalyze the electrolysis of an analyte by transferring electrons between the analyte and the electrode via the redox compound. Further information regarding sensing chemistry can be found at U.S. Pat. Nos. 5,264,105; 5,356,786; 5,262,035; and 5,320,725, which were previously incorporated by reference in their entireties.

In use of the sensor module 100, a fluid sample (e.g., a blood sample) flows through the tapered portion 114 a and the sample transport portion 114 b of the passage 114 defined in the housing 104 and fills the analysis cell 112. As the analysis cell 112 fills with the fluid sample, the vent 111 allows air within the analysis cell 112 to be displaced by the fluid sample. Once the analysis cell 112 is filled with the fluid sample, a voltage can be applied between the electrodes 140, 142. When the potential is applied, an electrical current will flow through the fluid sample between the electrodes 140, 142. The current is a result of the oxidation or reduction of an analyte, such as glucose, in the volume of fluid sample located within the analysis cell 112. This electrochemical reaction occurs via the electron transfer agent in the sensing layer and an optional electron transfer catalyst/enzyme in the sensing layer. By measuring the current flow generated at a given potential (e.g., with a controller described herein), the concentration of a given analyte (e.g., glucose) in the fluid sample can be determined. Those skilled in the art will recognize that current measurements can be obtained by a variety of techniques including, among other things, coulometric, potentiometric, perometric, voltometric, and other electrochemical techniques.

Referring to FIGS. 5-9, each sensor module 100 can be coupled to a delivery arrangement 210 to form a cartridge element 200. The delivery arrangement 210 has a body 211 extending from a distal end 202 to a proximal end 204. The delivery arrangement body 211, which has a generally rectangular shape, includes a top 201, a bottom 203, a first side 205, and an opposite, second side 207. The body 211 can be manufactured (e.g., injection molded) separately from the sensor module 100.

The distal end 202 of the delivery arrangement body 211 includes a coupling member 220 that is configured to secure the delivery arrangement 210 to the skin piercing member anchor 106 of the sensor module 100. For example, the coupling member 220 can be laser welded, fixed with epoxy, or otherwise secured to the piercing member anchor 106. In one embodiment, the coupling member 220 is shaped and sized to fit or interlock with the skin piercing member anchor 106. In one embodiment, the opening 119 defined in the piercing member anchor 106 is a port through which an adhesive can be injected to secure the delivery arrangement 210 to the sensor module 100.

Referring to FIGS. 10-12, the delivery arrangement 210 includes a drug reservoir 222 containing a dosage of a drug (e.g., insulin) to be administered to the patient (e.g., a diabetic patient). In one embodiment, the delivery arrangement 210 can be pre-filled with the drug dosage (e.g., at the factory) prior to coupling the delivery arrangement 210 to the sensor module 100. In other embodiments, the drug dosage can be added to the delivery arrangement 210 after coupling the delivery arrangement 210 to the sensor module 100.

The delivery arrangement 210 also includes a piston chamber 224 extending axially along the body 211 and generally parallel to the drug reservoir 222. The piston chamber 224 is configured to contain a delivery arrangement for dispensing the drug dosage to the patient. The skin piercing member 108 of the sensor module 100 extends proximally from the skin piercing member anchor 106 into the piston chamber 224, thereby providing fluid communication between the piston chamber 224 and the cannula of the skin piercing member 108 at a distal end of the piston chamber 224 (see FIGS. 10 and 11).

An inner wall of the body 211 defines a port 226 that provides fluid communication between the drug reservoir 222 and the piston chamber 224. A vent 228 extends from the drug reservoir 222 to an exterior of the delivery arrangement 210 to enable the drug to flow from the reservoir 222 to the piston chamber 224. The piston chamber 224 includes a valve arrangement 238 configured to enable selective ingress of a drug dosage from the drug reservoir 222 into the piston chamber 224. The valve arrangement 238 inhibits egress of the drug dosage from the piston chamber 224 back into the drug reservoir 222.

In one embodiment, the valve arrangement 238 includes a differential check valve component configured to assist in controlling the flow of the drug dosage from the drug reservoir 222 to the piston chamber 224. In certain embodiments, the valve arrangement 238 is formed on a tube 230 arranged in the piston chamber 224. The tube 230 can be a polymeric tube that lines the piston chamber 230 (see FIG. 12). In one embodiment, the check valve 238 is integrally formed with a thin wall of the tube 230. In the example depicted at FIG. 12, the tube 230 is cut (e.g., laser cut) to form a flat valve 238 that aligns with and seats upon the side port 226 when the tube 230 is mounted within the piston chamber 224.

A piston rod 234 is slideably mounted within the piston chamber 224 such that the piston rod 234 can be moved generally coaxially with the skin piercing member 108 in a proximal or distal direction. A piston head is mounted at a distal end of the piston rod 234 to cooperate with the tube 230 to form a seal. Movement of the piston rod 234 in the proximal direction releases the valve arrangement 238 and enables ingress of the drug dosage into the piston chamber 224. For example, movement of the piston rod 234 in the proximal direction can slide the piston head proximal of the valve arrangement 238, thereby enabling the valve arrangement 238 to flex into the tube 230. Further movement of the piston head in the proximal direction draws the drug from the reservoir 222, through the valve arrangement 238, and into the piston chamber 224. The amount of drug entering the piston chamber 224 depends at least partially on the amount by which the piston rod 234 is proximally drawn. Subsequent movement of the piston rod 234 in the distal direction expels the drug dosage from the piston chamber 224 through the skin piercing member 108.

In general, the cartridge element 200 includes exterior structures configured to allow a plurality of the cartridge elements 200 to be stacked one on top of the other to form a cartridge assembly 250 (see FIGS. 13-19) or magazine that can be loaded into a monitoring and delivery system (e.g., a glucose monitoring and insulin delivery system) 300 (see FIG. 20) as a unit. For example, the delivery arrangement 210 of the cartridge element 200 includes a first and second slots 216 extending along a length of the body 211 between the distal end 202 and proximal end 204. The first slot 216 extends along the first side 205 of the housing 211 and the second slot (not shown) extends along the second side 207 of the housing 211. The slots 216 are generally parallel to an axis C of the cartridge element 200 (see FIG. 11). By generally parallel, it is meant that the slots 216 are parallel or almost parallel to the axis C.

The delivery arrangement 210 also includes first and second rails 212, 214 that are generally parallel to the axis C of the cartridge element 200. The first rail 212 extends from the top 201 of the body 211 along the first side 205 and the second rail 214 extends from the bottom 203 of the body 211 along the second side 207. In one embodiment, each of the rails 212, 214 is generally L-shaped and faces inwardly (see FIG. 9). The rails 212, 214 of each body 211 are configured to protrude into the slots 216 of adjacent delivery arrangements 210 in the cartridge assembly stack 250.

When a first cartridge element 200 a is stacked on top of a second cartridge element 200 b, the second rail 214 of the cartridge element 200 a fits within the first slot 216 of the second cartridge element 200 b. The first rail 212 of the second cartridge element 200 b fits within the second slot of the first cartridge element 200 a. With this slot configuration, the second cartridge element 200 b can be connected to the first cartridge element 200 a by sliding the second cartridge element 200 b relative to the first cartridge element 200 a such that slot 216 of the second cartridge element 200 b laterally receives the first rail 212 of the first cartridge element 200 a and such that a rail 214 of the second cartridge element 200 b is laterally received within slot 216 of cartridge element 200 a. Cartridge element 200 b also can be disconnected from cartridge element 200 a by sliding.

In general, a cartridge element 200 can be loaded as sub-components into an analyte monitoring and drug delivery system. For example, FIG. 20A is a schematic block diagram of one example monitoring and delivery system 300 configured to determine an analyte level (e.g., glucose level) of a patient and deliver a drug dosage (e.g., insulin) based on the determined analyte level. The cartridge assembly 250 can be loaded into the monitoring and delivery system 300. For example, the monitoring and delivery system 300 shown in FIG. 20A contains five cartridge elements 200A-200E.

The monitoring system 300 includes an actuator 310, a controller 320, a signal input 330, and a user interface 340. The actuator 310 is generally configured to operate the cartridge element 200 (e.g., to obtain a fluid sample from a patient, to dispense a drug dosage, etc.). In some embodiments, the actuator 310 can be mechanically connected to the cartridge element 200 by a rod, piston, or other type of mechanical connector. Alternatively, the actuator 310 can provide movement instructions to the cartridge element 200 via an electrical connection.

In general, the controller 320 includes a processor 322, memory 324, and metering electronics 326. The controller 320 instructs the actuator 310 when to operate the cartridge element 200. For example, the controller 320 can instruct the actuator 310 based on a signal received at the signal input 330. In another embodiment, the controller 320 can instruct the actuator 310 based on instructions received from the user interface 340. The controller 320 also can instruct the actuator 310 to eject a spent cartridge element 200 from the system 300. Typically, each cartridge element 200 is actuated once and then discarded from the system 300. In other uses, however, the cartridge element 200 can be utilized multiple times.

The signal input 330 receives the signal generated at the electrodes 140, 142 of the sensor module 100 of one of the cartridge elements 200 and provides the signal to the controller 320 for analysis. For example, the signal input 330 can obtain the signal via a connection 332 (e.g., a wire, conductive tracing, or other type of electrical conductor) extending between the signal input 330 and the electrode contacts 148, 150. The metering electronics 326 and processor 322 analyze the signal to determine an analyte concentration level (e.g., a blood glucose reading) or other desired information.

The actuator 310 is generally configured to manipulate the cartridge element 200 to obtain a fluid sample by driving the skin piercing members 108 of one of the cartridge elements 200 between the extended and retracted positions. For example, the actuator 310 can be configured to push the respective skin piercing member anchor 106 in a distal direction relative to the analysis cell housing 104 to inject the piercing member 108 into the skin. The actuator 310 also can pull back the piston rod 234 in the piston chamber 224 to draw fluid through the piercing member 108, through the passageway 114, and into the analysis cell 112. Subsequently, the actuator 310 pulls the skin piercing member anchor 106 in a proximal direction relative to the analysis cell housing 104 to withdraw the piercing member 108 from the skin.

The actuator 310 also can be configured to cause the cartridge element 200 to deliver a drug dose. For example, in one embodiment, the actuator 310 can be configured to inject the piercing member 108 at an appropriate depth into the skin of the patient. In another embodiment, the piercing member 108 remains in the skin after obtaining the fluid sample until the drug dosage has been dispensed. The actuator 310 also can be configured to slide the piston rod 234 proximally to fill the piston chamber 224 with a drug dosage from the drug reservoir 222 and to slide the piston rod 234 distally to expel the drug dosage from the piston chamber 224.

In general, the amount of drug drawn from the reservoir 222 into the piston chamber 224 depends on the distance over which the piston rod 234 is proximally drawn. For example, drawing the piston rod 234 from a first position D1, in which the piston rod 234 closes the valve arrangement 238, to a second position D2, in which the piston rod 234 releases the valve arrangement 238, causes a first quantity of drug to enter the piston chamber 224 from the drug reservoir 222 (see FIG. 20B). Drawing the piston rod 234 from the first position D1 to a third position D3, where position D3 is proximal to position D2, causes a second quantity of drug to enter the piston chamber 224 where the second quantity of drug is greater than the first quantity of drug.

The controller 320 determines an appropriate dosage of the drug based on the analysis of the fluid sample and determines the distance over which the piston rod 234 should be drawn to effectuate the dosage. For example, the controller 320 can determine an appropriate dosage of insulin based on a determined blood glucose level of the patient. The correlation between the analyte concentration level and the appropriate drug dose (e.g., one or more tables of values, algorithms, etc.) can be stored in the memory 324. The correlation between the dosage quantity and the distance over which the piston rod 234 is drawn also can be stored in memory 324.

In one embodiment, the controller 320 causes the actuator 310 to draw substantially all of the drug dosage contained in the drug reservoir 222 into the piston chamber 224. In other embodiments, however, the controller 320 causes the actuator 310 to draw only a portion of the drug dosage contained in the drug reservoir 222 into the piston chamber 224. In some embodiments, the controller 320 causes the actuator 310 to draw less than half of the drug dosage into the piston chamber 224. Indeed, in some embodiments, the controller 320 causes the actuator 310 to draw less than a third of the drug dosage into the piston chamber 224. In other embodiments, however, a predetermined amount of drug is dispensed from each cartridge element 200.

In some embodiments, the controller 320 also causes the user interface 340 (e.g., a display screen 342) to indicate the determined analyte concentration level to the user. Other information (e.g., the determined dosage) also can be presented to the user via the user interface 340. In one embodiment, the display 342 is a visual display. In other embodiments, an audio display also can be used. In addition, a user can provide information to the controller 320 via the user interface 340 (e.g., buttons, switches, etc.). For example, the user can initiate operation of the cartridge element 200 by actuating a start interface (e.g., button).

The body 211 of the delivery arrangement 210 can have structures that facilitate mounting the delivery arrangement 210 relative to one or more components of the overall monitoring and delivery system 300. For example, one side of each delivery arrangement 210 can define a slot 215 (see FIGS. 5 and 7) by which the delivery arrangement 210 can be manipulated. In one embodiment, an actuator arm (e.g., arm 412 of FIG. 21) can be inserted into the slot 215 to push and pull the delivery arrangement 210 in a proximal and distal direction. In certain embodiments, a component of the controller 310 can couple to a connector 236 mounted at a proximal end of the piston rod 234. In one embodiment, the connector 236 defines an actuator engagement slot 237 configured to fit with the corresponding component of the controller 310 to enable the controller 310 to selectively move the piston rod 234.

In use, the cartridge element 200 is coupled to a first axial drive mechanism 410 of the monitoring and delivery system 300 and the connector 236 of the piston rod 234 is connected to a second axial drive mechanism 420 of the monitoring and delivery system 300 (see FIGS. 21-24). The axial drive mechanisms 410, 420 are configured to drive the cartridge element 200 and piston rod 234 along the axis C (FIG. 11) of the cartridge element 200. Each of the axial drive mechanisms 410, 420 includes a drive gear 412, 422 and a drive arm 414, 424, respectively. Each drive arm 414, 424 defines a toothed section 416, 426, respectively, which interacts with the respective drive gears 412, 424 to move each arm 414, 424 in the proximal or distal direction.

In the example shown in FIGS. 25-26, each drive gear 412, 422, 432 can be powered by a motor 411, 421, 431, respectively. In certain embodiments, the motors 411, 421, 431 can include stepper motors that drive the pinion gears 412, 422 and 432. The motor 411 functions to drive the delivery arrangement 210 of the bottommost cartridge element 200 along the axis C of the cartridge element 200. The pinion gear 412 of the motor 411 drives a gear rack 414 proximally and distally along an axis parallel to or coaxial with the axis C of the cartridge element 200. The gear rack 414 includes a tab 418 that fits within a corresponding notch 215 defined by the body 211 of the delivery arrangement 210 to prevent relative axial movement between the gear rack 414 and the delivery arrangement 210.

Motor 421 functions as a piston actuator for driving the piston rod 234 of the cartridge element 200 being used during a testing and delivery event proximally and distally. The pinion gear 422 of the motor 421 drives a gear rack 424 in a direction parallel to the axis C of the cartridge element 200. The gear rack 424 is fixedly coupled to a connector 428 (see FIG. 22) that mechanically engages the connector 236 provided at the proximal end of the piston rod 234. As shown at FIG. 22, the connector 428 includes a projection that fits within the slot 237 of the piston rod connector 236.

The motor 431 functions to laterally eject the bottommost cartridge element 200 from the cartridge assembly 250 after the bottommost cartridge element 200 has been spent (e.g., has taken a fluid sample, has taken a predetermined number of fluid samples, has dispensed its drug dosage, etc.). The pinion gear 432 of the motor 431 engages a gear rack 436 of the arm 434 that moves back and forth along an axis E that is generally perpendicular relative to the axis C of the cartridge element 300. The gear arm 434 includes a ram 438 that engages the bottommost cartridge element 200 to laterally move the cartridge element 200 along the axis E such that the bottommost cartridge element 200 is disconnected from the remainder of the stack 250 and discharged from the monitoring and delivery system.

To initiate a fluid sample testing, the distal tip 102 of the analysis cell housing 104 is pressed against a test site on the patient. The first and second axial drive mechanisms 410, 420 are simultaneously initiated to drive the body 211 and the piston rod 234 of the cartridge element 200 in unison in a distal direction. The analysis cell 104 portion of the cartridge element 200 is held in a generally fixed location. Accordingly, driving the body 211 of the delivery arrangement 210 distally causes the flexible linkage 130 of the cartridge element 200 to compress and the skin piercing member 108 to enter the patient's tissue at a first depth suitable for drawing a fluid (e.g., blood) sample.

The fluid sample flows into the analysis cell housing 104 and an analyte (e.g., glucose) reading is generated at the electrodes 140, 142 and sent to the processor 320 of the monitoring and delivery system 300. During fluid sampling, the skin piercing member 108 is preferably driven distally into the patient's tissue and then retracted immediately to provide the fluid sample for analyte analysis within the analysis cell housing 104. After the analyte level has been determined, the processor 320 calculates the amount of drug (e.g., insulin) that should be dispensed to the patient based on the analyte reading.

Thereafter, the second axial drive mechanism 420 pulls the piston rod 234 proximally relative to the body 211 of the delivery arrangement 210. As the piston rod 234 is pulled back, the piston head (not shown) passes by and releases the flapper valve 238, thereby allowing the flapper valve 238 to open such that drug from the drug reservoir 222 is drawn into the piston chamber 224. Preferably, the piston rod 234 is pulled back a distance calculated to draw the desired dosage of drug from the drug reservoir 222 into the piston chamber 224.

Once the desired dosage of the drug has flowed into the piston chamber 224, the first and second axial drive mechanism 410, 420 simultaneously drive the body 211 and the piston rod 234 as a unit in the distal direction. The body 211 engages the skin piercing member anchor 106. Accordingly, driving the body 211 distally while the analysis cell housing 104 is held fixed causes the flexible linkage 130 of the cartridge element 200 to compress, which causing the skin piercing member 108 to penetrate into the patient's tissue a depth suitable for delivering the drug into the tissue. Once the desired depth is reached, the movement of the body 211 in the distal direction is stopped, thereby stopping movement of the skin piercing member anchor 106 and the corresponding skin piercing member 108 in the distal direction.

Once the movement of the delivery arrangement body 211 stops, the second axial drive mechanism 420 continues to drive the piston rod 234 distally relative to the body 211 causing the drug within the piston chamber 224 to be forced from the piston chamber 224 through the interior of the skin piercing member 108 into the patient's tissue. As the drug is forced from the piston chamber 224, the flapper valve 238 prevents the drug from flowing from the piston chamber 224 back into the drug reservoir 222. Thereafter, the first and second axial drive mechanisms 410, 420 are again actuated to pull the delivery arrangement 210 and the piston rod 234 of the cartridge element 200 proximally in unison to cause the skin piercing member 108 to be withdrawn from the patient's tissue.

The delivery arrangement 210 also is coupled to a third drive mechanism 430 configured to drive the cartridge element 200 in a direction generally perpendicular to the axis C of the cartridge element 200. The third drive mechanism 430 can include a drive gear 432 and a drive arm 434 having a toothed section 436. The drive gear 432 interacts with the toothed section 436 of the drive arm 434 to move in a generally traverse direction to the movement of the other drive mechanisms 410, 420. In the example shown in FIG. 23, the drive arm 434 includes an abutment surface 437 and a flange 438 protruding outwardly from the abutment surface in the transverse direction. The flange 438 extends into the cavity 215 formed in the delivery arrangement 210 between the second rail 214. The abutment surface 437 presses against the exterior of the second rail 214 of the delivery arrangement 210.

Referring to FIGS. 24-29, the drive mechanisms 410, 420, 430 can be mounted onto a base 440 having a body 441 to form one example drive system 400 (FIGS. 24-26). The base body 441 has a first end 442, an opposite, second end 444, a first side 446, and an opposite, second side 448. A cartridge assembly 250 of one or more cartridge elements 200 can be loaded onto the drive system 400 to form a monitoring and delivery system (e.g., see FIGS. 27-29). The cartridge assembly 250 is loaded at the first side 446 of the body 441 such that each cartridge element 200 is oriented to extend between the first and second ends 442, 444 of the body 441 (see FIG. 25). The base body 441 can include a contact receiver 447 configured to contact the exposed portions of the electrode contacts 148, 150 protruding form the sensor module 100 of the bottommost cartridge element 200.

When the cartridge assembly 250 is loaded into the monitoring and delivery system, the bottommost cartridge element 200 of the stack is ready to be used. The first end 442 of the base body 441 defines an opening or slot 443 through which the distal end 102 of the sensor module 100 of the bottommost cartridge element 200 can access the test site on the patient. In one embodiment, the cartridge element 200 is positioned such that the distal end 102 of the sensor module 100 protrudes through the slot 443. In another embodiment, the distal end 102 is about flush with the first end 442 and the skin piercing member 108 protrudes through the slot 443 when moved into the extended position. It will be appreciated that the configuration of the slots 216 and rails 212, 214 provided on the body 211 of the delivery arrangement 210 enable the bottommost cartridge element 200 of the stack 250 to be slid along the axis C relative to the remainder of the cartridge elements.

After use of the bottommost cartridge element 200, the slot arrangement 216 of the body 211 allows the spent cartridge element 200 to be disconnected easily from the remainder of the cartridges and laterally ejected from the monitoring and delivery system. The first side 446 of the base body 441 defines a slot 445 extending between the first and second ends. Typically, the slot 445 of the first side 446 opens into the slot 443 defined in the first end 442 of the body 441. The third drive mechanism 430 pushes the delivery arrangement 210 of the bottommost cartridge element 200 in a transverse direction relative to the remainder of stacked cartridge elements 250 to disengage the bottommost cartridge element 200 from the stack and to eject the bottommost cartridge element 200 through the slot 445.

Referring to FIGS. 30-40, the drive system 400, metering electronics, and cartridge assembly 250 can be incorporated into an overall monitoring and delivery device. One example monitoring and delivery device (e.g., glucose monitoring and insulin delivery device) 500 shown in FIGS. 30-40 includes a device housing 510 having a top 501, a bottom 502, a first side 503, a second side 504, a front 505, and a rear 506. The top 501, a bottom 502, a first side 503, a second side 504, a front 505, and a rear 506 define a hollow interior 515 of the housing 510 in which the drive system 400 and metering electronics (e.g., the processor 320 of FIG. 3) can be installed. The metering electronics, such as a glucometer, are configured to determine analyte concentrations based on signals obtained from sensor modules installed within the device interior 515.

The first side 503 of the device housing 510 defines a first port 516 through which one or more cartridge assemblies 250 can be installed within the interior 515 of the housing 510 (e.g., see FIGS. 33-35). In general, the port 516 is sized and shaped to enable a cartridge assembly 250 to enter the interior 515 of the housing 510 through the port 516. In the example shown in FIG. 33, the port 516 is generally shaped to match a profile of the cartridge elements 200 of the cartridge assembly 250. A door 512 is configured to pivot about an axis 511 from a closed position (see FIG. 30), in which the door 512 covers the first port 516, to an open position (see FIG. 34), in which the door 512 allows access to the first port 516. In the example shown, the door 512 is generally curved. In other embodiments, the door 512 can be flat or any other suitable shape.

The cartridge assembly 250 is configured to be loaded into the monitoring and delivery device 500 by a patient. In general, when loaded into the monitoring and delivery device 500, the piston rods 234 of the delivery arrangements 210 are fully inserted within their corresponding piston chambers 224. As so positioned, the piston rods 234 engage the flapper valves 238 to hold the valves 238 in seated positions over the side ports 226. In this way, the drug contained in each of the delivery arrangements 210 is prevented from flowing from the drug reservoirs 222 to the piston chambers 224 until drug delivery is desired.

The cartridge assembly 250 is of sufficient size that it can be readily handled by a patient. However, since the sensor modules 100 of each cartridge element 200 in the assembly 250 are connected to the delivery arrangement 210 to form cartridge elements 200, the sensor modules 100 can be manufactured at smaller sizes since they never need to be handled individually by the patient. In one embodiment, the cartridge element 200 has a length of about 0.45 inches to about 0.75 inches, whereas the sensor modules 100 have lengths of about 0.6 inches to about 1.5 inches measured along the axis C and A, respectively, when the sensor modules 100 are arranged in the extended orientation. Multiple cartridge elements 200 are stacked or otherwise arranged in a cartridge assembly 250 to further facilitate handling of the cartridge elements 200.

When loaded into the device interior 515 through the first port 516, the cartridge assembly 250 is coupled to the drive system 400 and metering electronics contained within the housing 510. The sensor module 100 of the bottommost cartridge element 200 is connected to the metering electronics to facilitate transmission of analysis signals generated by the sensor module 100 to the metering electronics. For example, exposed contacts 148, 150 of the sensor module 100 of the bottommost cartridge element 200 can connect to the contact receiver 447 of the base body 441 of the drive system 400, which can be connected to the metering electronics.

The device housing 510 also includes a second port 517 defined in the bottom 502 (see FIG. 34). The second port 517 facilitates access between the patient test site and the distal end 102 of the sensor module 100 of the bottommost cartridge element 200 of a cartridge assembly 250 installed within the interior 515 of the housing 510. In use of the monitoring and delivery device 500, the distal end 102 of a cartridge element 200 being used to obtain and test a fluid sample projects through or is flush with the port 517 in the bottom 502 of the housing 510 to allow contact between the distal end 102 and the patient's tissue at the test site. In the example shown, the second port 517 remains exposed when the device 500 is not in use. In other embodiments, however, the device housing 510 can include a door or other cover for the second port 517 to protect the bottommost cartridge element 200 (e.g., from contaminants).

The device housing 510 also defines a third port 519 extending through the second side 504 of the housing 510 to provide access to the interior 515. The third port 519 is generally configured to enable one cartridge element 200 to be ejected from the interior 515 of the device housing 510 (e.g., see FIGS. 39 and 40). In the example shown in FIGS. 38-40, the third port 519 opens into the second port 517. In other embodiments, however, the third port 519 can be closed to the second port 517. A door 514 is configured to pivot about an axis 513 from a closed position (see FIG. 37), in which the door 514 covers the third port 519, to an open position (see FIG. 39), in which the door 514 allows access to the third port 519. In the example shown, the door 514 is generally L-shaped. In other embodiments, the door 514 can be flat or any other suitable shape.

The device housing 510 also includes a user interface 520 by which a user can input instructions and receives information from the device 500. In the example shown, the user interface 520 includes a display screen 522 on which data (e.g., an analyte concentration level, menu options, etc.) can be displayed arranged on the front 505 of the housing 510. The user interface 520 also includes input devices (e.g., buttons, knobs, toggle switches, track balls, dials, etc.) 524 and 526 arranged on the front 505 of the housing 510. The user input devices 524, 526 enable the user to program and/or actuate the drive system 400 and metering electronics within the housing 510. In other embodiments, the user interface 520 can include speakers to provide audible feedback to the user. Additional interface devices can include wireless output to computer, PDA or phone port, a battery charger port, a USB port, and a firewire port.

In certain embodiments, the monitoring and delivery device 500 is incorporated into a multi-purpose electronic device, such as a cell phone, PDA, or other such communication or data storage device.

Another example sensor module suitable for use with the delivery cartridge, driving system, and/or monitoring and delivery system is disclosed in copending application Ser. No. 61/114,829 (having attorney docket no. 11554.11USP1), filed Nov. 14, 2008, the disclosure of which is hereby incorporated by reference herein.

The above specification provides examples of how certain aspects may be put into practice. It will be appreciated that the aspects can be practiced in other ways than those specifically shown and described herein without departing from the spirit and scope of the present disclosure.

For example, an alternative method of monitoring and delivery includes inserting the piercing member into the skin at the depth prescribed for the drug (e.g., insulin) infusion. The piercing member has a laser drilled side port at a predetermined location proximal of the needle point. The laser hole is arranged in fluid communication with an annular chamber leading to the analysis cell.

The piercing member is inserted into the patient to about 100% of the depth required for drug infusion. When the piercing member reaches approximately 90% of the required tissue depth for drug infusion, the cannula of the piercing member is in fluid communication with the analysis cell through the side port. When the piercing member is arranged at 100% of the required depth, the side port is arranged distal of the entrance to the analysis cell. The side port is positioned within a narrower, occluding section of the passageway extending through the sensor housing. Accordingly, fluid is inhibited from passing from the piercing member through the side port.

When the piercing member is inserted at the required depth, the actuator (e.g., a pump) can be commanded to pull a fluid sample (e.g., a blood sample) from the patient up the cannula of the piercing member and past the side port. By then retracting the piercing member the distance of 10% of the insertion travel, the side port can be positioned within the annular chamber to align with the analysis cell. Subsequently, the actuator can be reversed to actively push a small fluid sample into the analysis cell through the side port.

After obtaining the fluid sample and analyzing the signals generated by the electrodes to determine an appropriate drug (e.g., insulin) dosage, the needle can then advance back to the 100% depth while the actuator draws an additional fluid sample (e.g., blood column) back up to the delivery arrangement 210 where the fluid sample is combined with the drug dose. Such a process eliminates dependence on capillary action and potentially reduces time required for analysis. 

1. (canceled)
 2. A monitoring device comprising: a plurality of cartridge elements disposed in a stack between a top-most of the cartridge elements and a bottom-most of the cartridge elements, each of the cartridge elements including a body, a skin piercing member, and a working electrode having sensing chemistry, the skin piercing member being movable relative to the body along a first axis between extended and retracted positions, the skin piercing member having a tip that is disposed internal of the body when the skin piercing member is in the retracted position, the tip of the skin piercing member being disposed external of the body when the skin piercing member is in the extended position, the cartridge element being configured to draw fluid through the skin piercing member to the working electrode, the cartridge elements in the stack being slidable relative to each other; a device housing defining a first port and a second port, the first port facing in a different direction than the second port, the first port being sized to receive the stack of cartridge elements, the second port being sized to enable ejection of individual ones of the cartridge elements, the device housing positioning the stack so that the bottom-most of the cartridge elements aligns with the second port while remaining within the device housing; metering electronics disposed within the interior of the device housing, the metering electronics configured to determine an analyte concentration level based on signals obtained with sensing chemistry at the working electrode of the bottom-most cartridge element; and an actuation arrangement disposed within the interior of the housing, the actuation arrangement being configured to obtain a fluid sample by driving the skin piercing member of the bottom-most cartridge element to the extended position, the actuation arrangement also being configured to eject the bottom-most cartridge element from the device housing via the second port.
 3. The monitoring device of claim 2, further comprising a first door coupled to the device housing, the first door selectively closing the first port.
 4. The monitoring device of claim 3, wherein the first door pivots relative to the device housing.
 5. The monitoring device of claim 3, wherein the device housing includes a second door that selectively closes the second port.
 6. The monitoring device of claim 5, wherein the second door pivots relative to the device housing.
 7. The monitoring device of claim 2, wherein the device housing defines a test slot with which the tip of the skin piercing member of the bottom-most cartridge element aligns so that the tip of the skin piercing member extends through the test slot when in the extended position.
 8. The monitoring device of claim 7, wherein the test slot faces in a different direction from the second port.
 9. The monitoring device of claim 7, further comprising a second door mounted to the device housing to selectively close the second port without covering the test slot.
 10. The monitoring device of claim 2, wherein each of the cartridge elements is elongate along a length that extends parallel to the first axis.
 11. The monitoring device of claim 2, wherein the bottom-most cartridge element is fully disposed within the interior of the device housing while the fluid sample is obtained.
 12. The monitoring device of claim 2, wherein the second port is configured to enable the bottom-most cartridge element to be ejected along an axis that is transverse to the first axis.
 13. The monitoring device of claim 2, wherein each cartridge element also includes a drug reservoir in selective communication with the skin-piercing member.
 14. The monitoring device of claim 13, wherein the drug reservoir holds insulin.
 15. The monitoring device of claim 13, wherein each cartridge element includes a delivery mechanism that draws a drug dose from the drug reservoir towards the skin piercing member.
 16. The monitoring device of claim 15, wherein the actuation arrangement controls the delivery mechanism of the bottom-most cartridge element.
 17. The monitoring device of claim 2, further comprising a user interface carried by the device housing, the user interface including a display screen and an input button.
 18. The monitoring device of claim 2, wherein each cartridge element includes a piston chamber and piston rod that cooperate to obtain the fluid sample through the skin piercing member.
 19. The monitoring device of claim 18, wherein the actuator arrangement manipulates the piston rod to draw the fluid sample into the piston chamber.
 20. The monitoring device of claim 2, wherein the cartridge elements interlock together in the stack to allow sliding movement of each cartridge element along the respective first axis while inhibiting movement along an axis transverse to the first axis.
 21. The monitoring device of claim 20, wherein each cartridge element includes rails and slots to allow the cartridge elements to interlock together. 